Another week, the same friendly smiles! Our research project is coming along (a bit slower this week - we will need to find some momentum for our last week of research). What have we achieved? We've got a very very rough results section completed. I'll do a big reveal next week and summarise the research rotation (next week is the last week of the research rotation!!).
Interesting website targeted at physicians, but it has some good info and newsletters that students may find interesting --> http://www.bpac.org.nz/
Michael Monaghan. Physiotherapy's fourth 'M' (alongside Mackenzie, Mulligan, Maitland) in the field of manual therapy. Monaghan has integrated osteopathic and physiotherapy manual therapy techniques for the cervical spine. His book 'Spinal Manipulation: A Manual for Physiotherapists' has been a key text in his post-graduate teaching. Monaghan is widely known for his contribution to teaching manual therapy in New Zealand, and particularly to undergraduates placed in Nelson. He is a major draw card for choosing your fourth year placement in Nelson. Here's an article you should look in to:
Hing, W. A., Reid, D. A., Monaghan, M. (2003). Manipulation of the cervical spine. Manual Therapy. 8(1), 2-9.
Our tutorial with Michael Monaghan on Friday morning was extraordinary. We started with a list of case studies to work through - how we would apply manual therapy techniques to correct a problem (some cases had sneaky red flags). Monaghan's style is very biomechanically focused and requires reliable and accurate palpation skills, strong arthrokinematic knowledge and clinical reasoning. Monaghan's manual handling and ability to perform manual therapy in a range of positions, using various locking/stabilising techniques (or using alternative manual therapy techniques - mainly high velocity, low amplitude mobilisations) is incredible. Furthermore, he is a great teacher. We were shown how to assess and mobilise spinal segments C0-3, with an emphasis on C0 (occipitoatlantal). Other than fine-tuning our pistol manip and lumbar manip, Monaghan showed us a transverse gapping HVLA technique for the upper thoracic / C-T junction, and the pistol manip performed on a person in sitting.
Hot tip!
Here's one really basic aspect of the physical assessment that is often overlooked by clinicians. When assessing neck range of motion, in particular side flexion, the clinician must remember that the upper cervical joints function quite differently to that of the lower cervical joints. We typically remember that the C1-2 joint can flex whilst the other Cx joints extend (i.e. the double chin), or all segments can flex (i.e. the 'did I spill tomato sauce down my front'). Clinicians often ask their clients to side flex (bring your ear to your shoulder) and commonly believe that only one movement is occurring in the neck (side-flexion). Wrong! Sure, side flexion is occurring in the lower cervical spine, but there is a slight rotation at C0 to the opposite direction (to keep the head forward, eyes as level as possible), that is forgotten about. I.e. if you side bend your neck to the left, there will be compensatory right rotation at C0. Why is this important? Say your client has a headache that is brought on by neck rotation and side-flexing the neck in the physical examination, the clinician is probably going to get confused about where the problem lies - is it in the upper, lower, or a more global cervical neck problem? Well, the answer probably lies in the subjective assessment, but you will confuse yourself in the physical assessment if you forget about these movement couplings. It's always good to assess the upper and lower cervical spine, in particular manually assessing C0 in a physical examination of the neck.
Physio Matters!
It was an exciting week - I got to feature
(albeit, a cut-down version of what I had written) in the physiotherapy
magazine 'Physio Matters'. I had comments over my Skype research meeting on Tuesday, a tweet from @LeonMabire and a request to promote the NZ Physiotherapy Board's new summer scholarship for 3rd year student (see the end of this post). So there we go, this week I was famous in the small world of New Zealand physiotherapy. Here is the full exert that I had written for
the magazine:
Social
media is wonderful (mostly). We simply cannot get enough of it, and there is a
lot of it out there. It’s our daily addiction. Between all the weird and
wonderful content online, I can imagine (with some certainty) that we’ve all experienced physiotherapy
on social media. Facebook ads, physiotherapy memes and infamous physiotherapy
legends on Twitter and bloggers like @AdamMeakins ‘The Sports Physio’. Informative,
thought provoking, entertaining, interactive, great!
I’m a fourth year physiotherapy student from the University
of Otago and I have been using social media too. It has become apparent that
Physiotherapy New Zealand keeps tabs on social media, and has miraculously stumbled upon my blog. Now,
having been welcomed to write a short article for Physio Matters magazine, I
thought I would take this opportunity to share a little bit about my blogging
experience and my undergraduate experience of fourth year.
I write a weekly recount of my physiotherapy experiences in
a blog. I started writing my
blog in 2014 and have subsequently
covered every academic week in
a post… Unfortunately
it’s not an original idea. There’s not a lot of detail in each of my blog posts; just enough detail for my
friends and family to keep up-to-date
with my undergraduate experiences – this was the purpose of writing the
blog. I have since used it to reflect upon the journey I’ve had so far. Others might recognise it
as a promotional resource for studying physiotherapy in New Zealand – it is, after all, online and open
for everybody to view. I don’t claim to have written anything masterful,
but it is my personal little project and I am enjoying it.
As mentioned, I am currently a fourth year student. My peers
are placed around the South Island and mid-lower North Island. For the students who made Dunedin their
home, they will feel quite separated from friends, possibly family and a little lost for finding an equivalent
local ice cream parlour to Dunedin’s Rob Roy. This is the great
adventure of fourth year but settling into a new location for the year can be a
challenge. This is a challenge that I face. Luckily I’m placed in sunny Nelson. I'll take this moment to brag. Nelson
and the surrounding area is stunning and the weather is a bonus. Don’t be
jealous, just come and visit – bring your tramping boots.
Blogging
whilst away from my family and friends has become quite useful for letting them
know that I'm alive and well, but I've recently discovered that being in a new
location away from the people you usually hang-out with will leave you feeling quite
isolated. Social media does not replace having a catch-up in person or over the
phone. Chatting about the experiences had by your peers is very necessary for
both your mental health and being effective on your placement – the placement
itself can be quite stressful too. My clinical educator kindly reminded me of
this, but some things you've got to learn the hard way.
I have had
many great moments over my first placement this year, lots of laughs with
clients and made to feel like one of the team by physiotherapists and other
healthcare staff. Luckily for me I will have more placements in Nelson
Hospital. Social media is wonderful (mostly) and I shall continue my weekly
blog updates for the year, amongst more person-to-person interactions (I think
I’ve learned that lesson now). Fourth year is great, but not without its
challenges. Embrace these challenges with the company and wisdom of others.
Written by
Phil Butler, 4th Year Physiotherapy Student.
Also in social media, as alluded to by Leon Mabire, the School of Physiotherapy was looking good on YouTube - the promotional video for the school was released to the public this week, and what a fantastic video it is.
A friend and I went on a mission to find some more DOC huts around Nelson. The three huts that we visited would be three of the easiest huts there are around the region - so no excuses not to look these up online and get out to walk them (@LeonMabire, you'll be pleased about all this walking I'm advocating). The huts are Bushline Hut (Nelson lakes national park), Flora Hut and Mt Arthur Hut (Kahurangi national park). Both starts of the walking tracks are about 1h drive from Nelson and the loop tracks can be done within 4h (thereabouts).
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| Mt Arthur Hut, Kahurangi National Park |
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| Flora Hut, Kahurangi National Park |
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| Bushline Hut, Nelson Lakes National Park |
Back to the topic of research! You'll be quite aware that there is a research module in the 4th year of physiotherapy (unless you've mistaken it for a tramping module - I can see how that might happen). The NZ Physiotherapy Board (the team that will issue you with your licence to touch / registration as a physiotherapist at the end of your degree... not to be confused with Physiotherapy New Zealand who I've mentioned earlier in the post about Physio Matters magazine) are offering 3rd year physiotherapy students a summer research opportunity to the tune of $5000 (you'll like the sound of that). What better way to get some paid practice for 4th year! But to trump that, you will also be doing a great service to Physiotherapy in New Zealand. All the details you need are online.
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